| NPI | 1174740351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 507763) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 24933) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2009-11-04 |